Epidemiology of herpes simplex virus in children by detection of specific antibodies in saliva

Objectives. To facilitate the study of the prevalence of herpes simplex vir us (HSV) infection and its determinants in children, we developed a noninva sive saliva test. Methods. A capture enzyme-linked immunosorbent assay (ELISA) for the detect ion of IgG to HSV in saliva was developed, validated against a commercial s erum ELISA in 110 children and 187 adults and used in a cross-sectional pop ulation-based study including 2048 children ages 1 to 17 years, recruited i n day-care centers and schools of Geneva, Switzerland. Demographic and soci oeconomic determinants of HSV prevalence were studied. Results. The sensitivity and specificity of the saliva assay were 94.1 and 95.5%, respectively, compared with the commercial serum ELISA. Participatio n in the cross-sectional study was 86.6%. The overall prevalence of anti-HS V IgG was 23.9%. It increased with age up to 7 years, reaching a plateau at 35% without evidence for day-care or school transmission. The main determi nants of prevalence were region of national origin and parents' professiona l category. Conclusions. This new saliva-based assay proved its feasibility in the firs t population-based study of HSV prevalence in children that uses saliva, co nfirmed its validity by identifying determinants of prevalence consistent w ith previous reports and yielded new information, such as the lack of influ ence of day-care attendance, in the population studied.